Dept. of Anaesthesiology. K.G.M.C.H.

1. Dept. of Anaesthesiology. K.G.M.C.H. BASIC LIFE SUPPORT GUIDELINES

2. RESUSCITATION • Means Cardiopulmonary resuscitations • Anywhere Anybody can do

3. CPR… • Considered when an individual cannot adequately breathe and maintain circulation to vital organs.

4. WHY& WHEN TO DO IT ? • Without CPR , irreversible brain damage occurs within 3-4 minutes • Should be done immediately by a bystander • TIME is the crucial factor here to decide the survival

5. Minutes counts... • when the heart stops, damage occurs to the Brainwithin < 5 minutes • startBLSearly

6. CPR… • BLS ACLS • ALS ANLS • CPCR – Cardio Pulmonary Cerebral resuscitation

7. CPR… ABCDEF How ? • Airway • Breathing BLS • Circulation • Drugs • ECG ACLS • Fibrillation

8. The Sequence of BLS • Establish Unresponsiveness • If no response call for help • Start BLS------- A- Airway B- Breathing C- Circulation

9. CPR… RECOGNITION Is crucial in BLS Determine • Unresponsiveness • Breathlessness • Pulselessness

10. No victim should undergo CPR until the need for resuscitation is established.

12. 2. Check the Victim and see if he responds GentlySHAKE his shoulder Ask loudly “Are you all right?”

14. 3A. Responds by answering or moving • Leave him in the position. • Reassess him regularly.

15. 3B. If no response • SHOUTfor help (Call for defibrillator) • Turn to his back and open airway. • HEAD TILT Hand on forehead. • Remove any visible obstruction. • CHIN LIFT finger tips under the point of chin. Avoid head tilt in Trauma

16. Emergency CPR… • Activation of EMS • Call for help • Call for ambulance services

17. BLS ALGORHYTHM CHECK RESPONSIVENESS A OPEN AIRWAY B CHECK BREATHING ventilation C CIRCULATION

18. CPR… Airway - First basic skill • Head tilt • Chin lift • Jaw thrust • Airways • ET intubation • Newer airways

19. CPR… AIRWAY Jaw thrust Chin lift Head tilt

20. CPR… Breathing – Second basic skill • LOOK for chest movement • LISTEN for breath sounds • FEEL for air on your cheek • 2 slow effective rescue breathing

21. LOOK, LISTEN AND FEEL LOOK LISTEN FEEL

22. 5A. Breathing Normally • Turn him into recovery Position. • Send or go for help. • Check for continued breathing.

23. Recovery position. To maintain a good airway To minimize the risk of aspiration

24. Recovery Position • To Maintain a good airway. • To Minimize the risk of aspiration.

25. 5B. Not Breathing Rescue breathing • Ensure head tilt and chin lift. • Pinch the Nose. • Two Slow effective breaths. Rise and fall of the Chest

26. Rescue Breathing • Required if breathing is absent or inadequate • Give 2 slow breaths sufficient to make the chest rise • Adult: Over 2 seconds • Child & Infant: Over 1 – 1 ½ seconds

27. Rescue Breathing Techniques • Mouth-to-Mouth • Mouth-to-Barrier • Mouth-to-Nose • Mouth-to Mask • Bag-mask device  

28. Any difficulty achieving an effective breath. • Recheck Victims mouth. • Recheck head tilt and chin lift. • Make up to 5 attempts. • Even in unsuccessful, move on to assessment of circulation.

29. Absent carotid pulse. Lay Rescuer. Normal Breathing. coughing Movement. NO - Circulation • Sign of Cardiac arrest. • No More than 10 Sec.

30. Identify Adam’s apple (Thyroid Cartilage). Slide down to the groove. Palpate pulse in the groove. Never Palpate on both sides simultaneously. CAROTID PULSE

32. 7A. Circulation Present • Continue rescue breathing. • Recheck rescue breathing. • Normally breathing  Recovery Position.

33. 7B. No signs of Circulation • Chest compressions. • Identity middle of Lower half of Sternum. • compressions by heel of the hands. • After 15 Compressions tilt the head, lift the chin and give 2 effective breaths.

34. Chest Compressions • No pulse present START CHESTCOMPRESSIONS • Compression Rate: Adult, Child, & Infant – 100/min

35. TECHNIQUE OF EXTERNAL CARDIAC COMPRESSION • Rescuer to one side of the patient • Patient’s chest exposed and xiphisternum identified • Xiphisternum –Bony prominence in the mid line at the junction of lower borders of the ribs • The index and middle fingers of the lower hand placed on the xiphisternum and heel of the other hand is placed adjacent to them on the sternum

36. Heel of the second hand placed on the back of the hand on the sternum • Fingers may be interlocked • Sternum depressed vertically4-5cm and then released rapidly • Repeated at a rate of 80-100/minwith compression and relaxation each taking the same length of time

37. Locate rib cage

38. Position your hands over middle of lower half of sternum and fingers away from Chest

39. Compression of Chest • Arms Vertical • Arms Straight • Press Depress • 4-5Cm

41. CPR One Rescuer Chest compressions Breathing 2 x 15 x

42. Two rescuers

43. Depth of Compression • Adult: 1 ½ - 2 inches or enough to generate a pulse • Child & Infant: 1/3 – ½ the depth of the chest or enough to generate a pulse

44. Continue Resuscitation Until • Qualified help arrives and takes over. • Victim shows signs of life. • You become exhausted.

45. Reassessment(10 seconds) • Should be performed after the first minute of CPR and every few minutes thereafter •  If no pulse- resume CPR •  If pulse and breathing present- place in recovery position •  If pulse present but no breathing- provide rescue breathing

46. BLS Algorithm CHECK RESPONSIVENESS Shake & Shout Head tilt / Chin lift OPEN AIRWAY Look, Listen and Feel CHECK BREATHING 2 Effective Breaths BREATHE ACCESS CIRCULATION 10 seconds only Signs of a Circulation CIRCULATION PRESENT Continue Rescue Breathing NO CIRCULATION Compress Chest Check Circulation every Minute 100 Per Minute 15:2 Ratio

47. CPR… • Nutshell

48. ACLS • Special equipments and techniques • ECG monitoring • Defibrillation • iv access • Drug therapy • Post resuscitation care

49. NOW HE IS SAFE IN HELPING HANDS Thank you